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Developmentally Appropriate Practice for Infants and Toddlers

Expanding Quality for Infants and Toddlers: Colorado Implements Touchpoints Wendy Watson, Jo Koehn,  and Lisa Desrochers


ometimes, when you least expect it, wonderful things happen. In 2005, at a national conference, a colleague and I (Wendy) were preparing to leave our session when a large crowd rapidly began filling the room. As it was clear that the crowd knew something we didn’t—and since the influx was so massive it seemed impossible to exit the room!—we reclaimed our seats and stayed for the following session. Over the next hour we listened to stories about the impact of Brazelton Touchpoints on teachers and home visitors, as well as on families and young children. (See “What Is Brazelton Touchpoints?”) Our experience was the first step in the establishment of a network of Touchpoints teams in Colorado. As coordinators of local early childhood coalitions working to improve the quality of early childhood programs, my colleague and I had been looking for ways to support early childhood professionals in their efforts to strengthen partnerships with families, support young children’s healthy emotional development, and continue to promote developmentally appropriate practices. We didn’t want to establish an additional curriculum or institute training in a specific program; rather, we wanted to use an approach to strengthen the programs and services already in place. We had heard early childhood professionals in Colorado express frustration about forming partnerships with families and about embracing the role those partnerships play in quality early care and education. Underlying this frustration was great uncertainty about how to form meaningful relationships with families. At the same time, professionals in early care and education, physical and mental

Wendy Watson, MA, is the founder of Watson Consulting, specializing in leadership, early childhood development, and teaching adults. Her 25-plus years of experience include work with Head Start/Early Head Start, child care, home visitation, and early childhood systems initiatives. Jo Koehn, MSW, is the director of the Expanding Quality in Infant/Toddler Care Initiative at the Colorado Department of Education. Her work focuses on improving the lives of infants and toddlers and of those who care for them.

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Lisa Desrochers, MEd, is the program director of special initiatives at the Brazelton Touchpoints Center® at Boston Children’s Hospital. Lisa has extensive experience in the early childhood field, and she works at Touchpoints in a number of capacities, including project manager, trainer, and content consultant.

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What Is Brazelton Touchpoints? Brazelton Touchpoints is a strengths-based approach to working with families. It combines understanding of child development with respect for the importance of key relationships in young children’s lives. Touchpoints grew out of pediatrician T. Berry Brazelton’s 60-plus years of infant research and practice, and is based on an extensive body of scientific research, practice, and program evaluations.   Health and human services and early childhood education and care often focus on the deficits in child and parent relationships. All too often, professionals in the fields of early childhood education and health and human services focus on what is wrong, or not working, in child–parent interactions. This can leave families feeling undervalued and unwelcomed, and even cause caregivers to perceive families as unwilling to engage in partnerships. In its practical application, Touchpoints is a set of values, principles, and strategies professionals use to forge better partnerships with families, connect with parents’ strengths and vulnerabilities, and create a shared understanding of each child.   At the heart of the Touchpoints approach is the development of strong positive relationships to support and promote the best possible developmental outcomes for children (Singer 2007). With Touchpoints, early childhood professionals gain understanding of child and family development and increase their ability to communicate with diverse families. The approach empowers parents to recognize and assert their expertise as their child’s first teacher and feel valued as leaders in their child’s learning and development. Children are nurtured by strong relationships with all who care for them, including parents, family members, and teachers. These essential relationships support optimal development.

health, and family support were struggling to unite their efforts into a cohesive system of supports for families with young children in their communities. These thoughts came to mind as we sat and listened in the Touchpoints session. We knew we had found what we were looking for and returned home knowing the next step was to find a way to bring Touchpoints to Colorado.

Connecting with Colorado’s Expanding Quality Initiative   As we explored how to bring Touchpoints to Colorado, we thought of the Expanding Quality in Infant/Toddler Care (EQ) Initiative, a collaboration between the Colorado Department of Education and the Division of Child Care at the Colorado Department of Human Services. Since 1999, the EQ Initiative had been steadily developing a network of Colorado infant/toddler specialists focused on increasing the quality of infant and toddler care by improving practice and expanding the supports available to infant/ toddler teachers. The primary goal of the EQ Initiative is to increase the quality and availability of respectful, respon-

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sive care while helping communities expand their capacity to serve infants and toddlers and their families. Communities throughout Colorado work with the EQ Initiative to offer training and on-site coaching for infant and toddler teachers. At the same time we learned about Touchpoints, the EQ Initiative leadership was seeking innovative ways to strengthen and deepen early childhood teachers’ and providers’ knowledge base, particularly in working with families of infants and toddlers in group care.   The EQ Initiative readily embraced Touchpoints and provided the initial support, including funding, leadership, and connections to the existing EQ network of Colorado infant/ toddler specialists. The initiative established two Touchpoints community teams in 2005 and set the foundation for building a network of Touchpoints teams in Colorado. The goals and core values of the EQ Initiative fit with those of Touchpoints. The state-level EQ Initiative, the connections with local EQ infant/toddler specialist training teams, and the early childhood councils (community coalitions of local early childhood organizations and advocates) aided the integration of Touchpoints’ philosophy, principles, and strategies into Colorado’s early childhood system. The shared and compatible values, goals, and approaches of these groups led naturally to Touchpoints’ deepening EQ Initiative work.

Building the Touchpoints network Touchpoints allows us to work within the current system and bring about change through partnership rather than forcing change from the outside. It is about trust and respect and discovery and being able to accept differences with understanding and without compromising ourselves or our reasons for being there. — Director, Early Childhood Council

  The EQ Initiative’s three primary areas of impact for Touchpoints are individual practice, the professional development delivery system, and collaborative systems building. •  Local Touchpoints teams provide training for early childhood professionals to increase their skills in understanding and working with families, and to strengthen their developmentally appropriate practice. •  The state EQ Touchpoints team offers training for diverse groups of professionals, who then use the Touchpoints approach to support professional development experiences for early care and education teachers.


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Developmentally Appropriate Practice for Infants and Toddlers

•  Local early childhood councils use Touchpoints strategies to build effective collaborative relationships among early childhood organizations.

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  Each Touchpoints team has members from the fields of early childhood education, physical and mental health, early intervention, and higher education. The first two Touchpoints teams, in partnership with the EQ Initiative leaders, spent a year establishing and implementing the first Touchpoints trainings and follow-up support for participants to implement the approach in their work with young children and their families. The initial trainings were workshops for infant/toddler teachers. The workshops focused on the Touchpoints developmental and relational models and on reflective practice to promote the four Touchpoints goals: supporting optimal child development, healthy functional families, competent healthy professionals, and strengthening communities. By the end of that first year, the passion of the Touchpoints training team members, early childhood councils, and the EQ leadership had grown. They were passionate about Touchpoints’ ability to strengthen partnerships with families, expand developmentally appropriate practice in early childhood education settings, and bring together the mental health, family support, early education, and health care programs that serve families with young children. It was clear other Colorado communities needed access to this approach.

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  Expanding this work brought several challenges—how to expand Touchpoints training to rural and frontier communities, how to manage the expansion with limited resources, and how to be responsive to community culture. The EQ leadership and local Touchpoints team members addressed these challenges by creating a state-level Touchpoints team in 2006. The state team focused on building partnerships with rural communities and supporting the integration of Touchpoints’ philosophy and practice into communities statewide. This was done by partnering members of the state team with local Touchpoints trainers to provide trainings and implementation support for early childhood teachers in rural comThis cross-disciplinary munities. The rural partcollaboration shares the nership was designed to provide access to use of the Touchpoints Touchpoints in smaller approach, providing communities that would not otherwise have the continuity across setresources to support a tings and organizations Touchpoints team.   The statewide comthat serve families with munity integration effort young children. focused on offering trainings for the network of EQ infant/toddler specialists and other statewide partners, including early childhood council coordinators, physical and mental health care providers, and state leaders in early childhood. By creating this state-level team, the Touchpoints approach is being integrated into the early work at multiple levels. Local teams support integration of Touchpoints with those who work directly with families and young children, and the state team supports Touchpoints integration into the work of trainers, infant/toddler specialists, and consultants who work with early childhood professionals. Many infant/toddler specialists on local EQ training teams became passionate about the Touchpoints work and were key participants in building their community’s Touchpoints teams.   By the end of 2011, the Colorado Touchpoints network had grown to include nine Touchpoints teams serving 11 counties and the statewide EQ Initiative. Each local team consists of a cross-disciplinary group of trainers representing early education, physical and mental health, and/or family support. The partnership between the state-level EQ Initiative and the local Touchpoints teams is one of encouragement and innovation. The result is a flexible system that bolsters, but does not limit, the work of local Touchpoints teams. Local teams have continued to promote the goals of the EQ Initiative while taking the message to additional groups, including health care providers, early intervention professionals, family support groups, early care and education programs, and children’s librarians. This cross-disciplinary collaboration shares the use of the Touchpoints approach, Young Children • September 2012

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Common themes become guiding principles   As the work expanded, the EQ Initiative leadership formalized a set of common themes as guiding principles across the EQ Initiative and the Colorado Touchpoints network. Each principle reflects the lessons learned from the EQ infant/toddler specialists’ work and Touchpoints teams’ work and is the basis for our integrated efforts to support quality infant and toddler child care.

  Build strong, healthy relationships. The field of early childhood education has firmly established the importance of relationships. Research over the past 10 years illustrates the importance of relationship-based practice. Relationships are the foundation that supports young children’s learning and development (Baker & Manfredi/Petitt 2004; National Scientific Council on the Developing Child 2004). Relationships are the primary element on which we built the EQ Initiative. However, putting this knowledge of the importance of relationships into practice can often be challenging. One key strategy is shifting from a deficits-based to a strengths-based model for working with others. That is, we intentionally seek out what is working and expand on that, rather than pointing out what isn’t working and trying to fix it. We practice the strengths-based approach in all of our work—with families of young children, with colleagues, and with participants in training and coaching relationships. For example, when an infant/toddler specialist is training or coaching, she looks for what a teacher does well and comments on that first. This begins the conversation with what is working, thus strengthening the relationship between the specialist and teacher. This sets the stage to work together to identify what isn’t working and using this shared understanding of what is working and isn’t working to determine what to do next.   Observe and understand children’s behavior. To build effective relationships and support optimal child development, we must take time to be present and notice what is happening. When we pay close attention and identify what children are telling us through their behavior, the process of understanding and responding can unfold. By joining with families to observe behavior, we can co-create how best to support children’s development. For example, when a child who was doing well with toilet training begins to have accidents, the teacher and parents observe what is happening. Then they explore what they observed and discuss what it means to the child, the parent, and the teacher. Based on this shared information, together they determine how to proceed.   This focus on understanding the meaning of children’s behavior deepens relationships and strengthens the supYoung Children • September 2012

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providing continuity across settings and organizations that serve families with young children.

port system. Carter and Curtis (2002) capture this when they state, Looking closely, we can see the influence of cultural patterns and learn more about ourselves, our preferences, our biases, and our blind spots. Discussing our observations with coworkers and the children’s families helps us to see things from different perspectives, allowing each of us to transcend the limitations of our own points of view. (xiii)

  Respect children’s relationships with their families. Family–child relationships are the first and most important relationships in children’s lives. When early childhood professionals enter into a shared caregiving experience with families, the partnership supports both the family– child relationship and healthy child development. Child outcomes across all domains are associated with the quality of the relationships between children and their primary caregivers. “Substantial research supports family involvement, and a growing body of intervention evaluations demonstrates that family involvement can be strengthened with positive results for young children and their school readiness” (Weiss, Caspe, & Lopez 2006, 1). My [teaching] team members have a greater understanding and respect for the role of the parent in the life of a young child. The fact that [teachers] may spend a great deal of time with the child is balanced by the fact that they are only a part of the child’s life for a small period of time and the parent has a lifetime with the child. That was an “aha” moment for many of the teachers we have worked with. — Center Director


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Developmentally Appropriate Practice for Infants and Toddlers

  Recognize families’ strengths and expertise. Discovering and honoring the strengths of families and their knowledge of their child is fundamental to the shift from a deficits-based to a strengths-based approach to teacher– family partnerships. By assuming that all parents have strengths and are the experts on their child, we challenge ourselves to seek strengths even when they seem difficult to find. For example, instead of assuming it is a problem when a father carries his 3-year-old into the program each day, the early childhood teacher looks for the positive intent of this behavior. Perhaps the parent is trying to alleviate the anxiety he believes the child has, or is offering a few moments of additional closeness before the busy day begins. This transforms our role from that of an expert who provides answers to families to that of an authentic partner with families. By joining with families and sharing expertise, we open myriad opportunities for how best to support children’s healthy development. Both the nursing staff/providers and family want what is best for the infant. All of them want to be competent and have areas of expertise. —  Early Childhood Professional

  Respect each child and family’s unique culture. Culturally competent caregiving is critical to achieving quality in infant and toddler care. The need to understand children’s experiences and nurture the home–school partnership is at the heart of developing this competence (Maschinot 2008). The integration of Touchpoints with the EQ Initiative connects the EQ themes of cultural respect and understanding with the Touchpoints tools and strategies for building effective partnerships with families. This integrated approach guides us in the process of learning from families about their family and child. It supports respectful conversations with families about their values and culture, particularly around caregiving. After this training, I feel that providers have a better understanding of where a parent might be coming from and have a better place to begin to communicate or a greater comfort in deepening communication with families. — Touchpoints Team Member

  Use reflective practice. Taking time to consider how we work with infants and toddlers and their families, in addition to why we engage in specific practices, is the foundation of integrating knowledge into our daily interactions with them. We accomplish this through a variety of methods, including reflections during trainings, guided journaling, discussions with colleagues, coaching, and personal reflections. Reflective practice provides opportunities to integrate knowledge with our own experiences and thereby inform our work with families, infants, toddlers, and other 62

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professionals (Fenichel 2005; Wittmer & Petersen 2006). For example, an early childhood teacher reflects daily by journaling before going home each day. Through this process she considers what she did; how the children, parents, and other staff responded; and how she feels about the day. As this unfolds, she identifies what worked well that she wants to continue to do, and opportunities to adjust and change what is happening. She also uses this technique to monitor the impact and results of incorporating a new routine into the program, thus creating a feedback loop that intentionally identifies what works well and opportunities to change and improve her practice. I frequently find myself trying to recognize what I am bringing to an interaction and asking other people involved to do so as well. —Touchpoints Trainer

  Consider children’s home experiences. When working with infants and toddlers, it is vitally important to consider the complex needs of the whole child, including the child’s individual development and what is occurring within the family. Job changes, family moves, and family members’ health issues can impact a child’s development. With this view of the whole child, we challenge ourselves to consider issues beyond our traditional areas of expertise as part of the supports provided to families.

  Partner with other professionals. Relationship-based care partnered with the collaborative approach creates opportunities to work with individuals from other disciplines. In turn, these relationships open the door to developing and maintaining the best possible supports for families. Research shows that the quality of the collaborative relationships among community stakeholders is contagious and may travel throughout the system to the teacher–family, teacher–child, and family–child relationships, even when these teachers, families, and children are not present in the collaborative group (Hicks 2010). For example, an early care and education teacher may work in partnership with a health consultant to determine how best to meet the needs of a child with an allergy. The helpful and supportive tone of the relationship between teacher and consultant will influence/translate to the interactions between the teacher and the child’s family. This strengthens the relationship between the teacher and family, ultimately increasing their ability to meet the child’s needs.

Results   Touchpoints has been part of the EQ Initiative in Colorado for seven years now. In reviewing the journey, we note several key impacts for individuals, the professional development system, and the communities where Touchpoints is integrated into the early childhood work. Young Children • September 2012

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Individual practice. Touchpoints has strengthened relationships between providers and families in Colorado’s Touchpoints network. Pre- and post-evaluations of knowledge and attitudinal change, administered before and after each of the first 14 Colorado Touchpoints training sessions, show an increase in participant knowledge of more than 67 percent, as well as an increase in positive participant attitudes about relationships with families. I use Touchpoints to slow my mind down and really listen to what parents are telling me. Before I respond to a parent, I run my thoughts through my Touchpoints filter. I then use the principles and assumptions to guide my interactions with families. — Early Childhood Provider

  Professional development system. The Touchpoints approach extends and deepens the learning from the EQ Initiative courses and other professional development experiences, especially around the topics of working with families as experts on their children and using the language of the child—describing what the child is doing to connect to and communicate with parents—to support optimal outcomes for children. Touchpoints supports the self-reflection that is essential to changing professional practice. It has been

helpful to have an approach that is not specific to the EQ Initiative or other professional development programs, because it provides a tool that caregivers and teachers can use throughout their practice, regardless of the early childhood program or setting in which they teach or the children’s ages.

  Community collaboration. Touchpoints has broadened EQ work by intentionally including professionals from other disciplines in community teams, bringing together more people to think deeply about young children. We use the values, principles, and assumptions of the Touchpoints approach to support collaboration within the early childhood community. This has created a structure in which participants value and explore different perspectives, and varied perspectives contribute to the development of next steps. What really struck me during and after the training is the principle of “valuing passion where you find it.” This shift in focus from feeling defensive at times with parents to recognizing their passion for their child, their family, their values has significantly impacted my practice and interactions with all people (including other professionals). — Early Childhood Mental Health Consultant

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Developmentally Appropriate Practice for Infants and Toddlers

Lessons learned

  Be open to new opportunities. When we had difficulty leaving our session at the conference many years ago, it would have been easy to become irritated about not having an easy exit route. We’re grateful that we remained open to what was in front of us and took advantage of this unplanned-for opportunity.   Build on what works well. There are so many programs and curricula available in the early childhood education field these days that it’s often tempting to add the latest new program; however, this isn’t always the best idea. Starting small, with two teams, allowed us to build on existing supports in the community and align with other services already working with infants, toddlers, and their families. This strategy ultimately strengthened all of our professional development work.   Follow your passion. When something ignites your passion, great things can happen. As we worked to integrate Touchpoints into the EQ Initiative, there were moments when we struggled and wondered if it would ever really happen. Funding, intricacies of integrating Touchpoints into existing work, and uncertainty in how it might be sustained over time all emerged as reasons to feel pessimistic. It was the passion shared across the partners in Colorado that has carried us through. Our work is to foster critical connections. We don’t need to convince large numbers of people to change; instead, we need to connect with kindred spirits. Through these relationships, we will develop the new knowledge, practices, courage, and commitment that lead to broad-based change. — Margaret Wheatley and Deborah Frieze, Using Emergence to Take Social Innovation to Scale

  Embrace diversity and collaborate with individuals from other fields. Although our work had traditionally been in the field of early care and education, we made an intentional decision to build multidisciplinary teams. This allowed us to establish relationships with professionals with varied expertise and to work with multidisciplinary training groups. We discovered new “kindred spirits” and increased the opportunities for shared learning.

  Look for goodness of fit. Key to the success of integrating Touchpoints with the EQ Initiative is the goodness of fit in values, goals, and approaches. This allows us to be consistent and congruent in our work to improve the quality of early care and education programs serving infants and toddlers. 64

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  Five important lessons have emerged from the implementation of Colorado’s EQ Touchpoints Network.

References Baker, A., & L.A. Manfredi/Petitt. 2004. Relationships, the Heart of Quality Care. Washington DC: NAEYC. Curtis, D., & M. Carter. 2002. The Art of Awareness: How Observation Can Transform Your Teaching. St. Paul, MN: Redleaf. Fenichel, E.S., ed. 2005. Learning through Supervision and Mentorship to Support the Development of Infants, Toddlers and Their Families: A Source Book. Washington, DC: ZERO TO THREE. Hicks, D. 2010. “Generating and Sustaining Commitment in Community Collaboration.” Paper presented at the Early Childhood Council Leadership Alliance, Denver, November 19, 2010. www.researchconnections. org/files/childcare/pdf/HicksCollaborativeCommitment_presentation.pdf. Maschinot, B. 2008. The Changing Face of the United States: The Influence of Culture on Child Development. Washington, DC: ZERO TO THREE. pdf?docID=6921. National Scientific Council on the Developing Child. 2004. Young Children Develop in an Environment of Relationships: Working Paper No. 1. reports_and_working_papers/working_papers/wp1. Singer, J. 2007. “The Brazelton Touchpoints Approach to Infants and Toddlers in Care: Foundation for a Lifetime of Learning and Loving.” Dimensions of Early Childhood 35 (3): 4–9. upload/file/SECA%20Radio/The%20Brazelton%20Touchpoints.pdf. Weiss, H., M. Caspe, & M.E. Lopez. 2006. “Family Involvement in Early Childhood Education.” Family Involvement Makes a Difference Brief No. 1. Cambridge, MA: Harvard Family Research Project. family-involvement-in-early-childhood-education. Wittmer, D.S., & S.H. Petersen. 2006. Infant and Toddler Development and Responsive Program Planning: A Relationship-Based Approach. Upper Saddle River, NJ: Pearson.

For further reading Brazelton, T.B., & J. Sparrow. 2006. Touchpoints: Birth to Three. 2nd ed. Cambridge, MA: De Capo Press. Brazelton, T.B., & J. Sparrow. 2006. Touchpoints: Three to Six. 2nd ed. Cambridge, MA: De Capo Press. Brazelton Touchpoints Center. 2011. “What Is Touchpoints?” www. Colorado Department of Education. Expanding Quality in Infant/Toddler Care Initiative. Singer, J., & J. Hornstein. 2010. “The Touchpoints Approach for Early Childhood Care and Education Providers.” In Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton, B.M. Lester & J.D. Sparrow, eds., 288–99. Malden, MA: Wiley-Blackwell.

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In 1962, the Perry Preschool Study set out to improve the lives of a small group of local children.

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Half a century ago, HighScope founder David Weikart launched a small-scale project to study the effects of a high-quality preschool program on children living in poverty. That modest effort grew into one of the most influential and well-regarded research studies—and educational models—in the world of early childhood. The study demonstrated that the right kind of preschool education can produce positive, long-term, real-life improvements. Today, the HighScope approach is being used by educators around the globe, and we continue to improve the lives of children by building on the Perry Study legacy.

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Expanding Quality for Infants and Toddlers: Colorado ImplementsTouchpoints